Crimi N, Palermo F, Ciccarello C, Distefano S M, Vancheri C, Cacopardo B, Mistretta A
Respiration. 1986;50 Suppl 2:206-8. doi: 10.1159/000195128.
Beta 2-adrenergic and anticholinergic drugs have shown an action in modulating bronchial hyperreactivity to various stimuli (chemical, physical, immunological, pharmacological). The aim of our study was to compare the efficacy of a combination of ipratropium bromide and fenoterol (Duovent) with the activity of single drugs in the prevention of histamine-induced bronchospasm. Twenty-six atopic asthmatic subjects were examined in a double-blind trial, during an asymptomatic period, with a FEV1 value not lower than 20% of the predicted normal value. During 4 consecutive days all patients received 2 puffs, respectively, of Duovent (200 micrograms fenoterol + 40 micrograms ipratropium bromide), fenoterol (400 micrograms), ipratropium bromide (80 micrograms) and placebo in a randomized order. PD20 values were evaluated after each drug administration: after 2 h in 16 patients and after 5 h in the other 10 patients. The data were modified to log values, and statistical analysis was performed by two-way analysis of variance. This study showed that Duovent and fenoterol have a protective effect against histamine-induced bronchospasm with a significant increase in the PD20 values 2 h (p less than 0.01) and 5 h (p less than 0.05) after treatment when compared to placebo. Duovent inhalation determined a more protective effect than other drugs but not significantly when compared to fenoterol. Some advantages in the modulation of bronchial reactivity could be seen from using Duovent because with the lower dose of the beta 2-adrenergic drug the same results could be obtained without side-effects.
β2-肾上腺素能药物和抗胆碱能药物已显示出对调节支气管对各种刺激（化学、物理、免疫、药理）的高反应性有作用。我们研究的目的是比较异丙托溴铵和非诺特罗联合制剂（多索茶碱）与单一药物在预防组胺诱发支气管痉挛方面的疗效。在一项双盲试验中，对26名特应性哮喘患者在无症状期进行检查，其第1秒用力呼气容积（FEV1）值不低于预测正常值的20%。在连续4天里，所有患者分别以随机顺序吸入2喷多索茶碱（400微克非诺特罗+80微克异丙托溴铵）、非诺特罗（400微克）、异丙托溴铵（80微克）和安慰剂。每次给药后评估PD20值：16名患者在给药后2小时评估，另外10名患者在给药后5小时评估。数据转换为对数值，采用双向方差分析进行统计分析。本研究表明，与安慰剂相比，多索茶碱和非诺特罗对组胺诱发的支气管痉挛有保护作用，治疗后2小时（p<0.01）和5小时（p<0.05）的PD20值显著增加。吸入多索茶碱比其他药物具有更强的保护作用，但与非诺特罗相比无显著差异。使用多索茶碱在调节支气管反应性方面有一些优势，因为使用较低剂量的β2-肾上腺素能药物就能获得相同效果且无副作用。
